肝囊型包虫病的超声诊断价值

目的：探讨肝囊型包虫病的超声诊断价值。方法：对超声诊断并经手术病理证实的236例囊性包虫病的275个囊肿进行了超声图像的分型分析。结果：单纯囊型67例、内囊分离型51例、多子囊型62例、实变型34例、钙化型22例,这5型代表了囊型包虫病的发生、发展、转归的不同阶段。结论：超声对包虫囊肿的诊断率高,简便易行,可明确包虫的寄生部位、大小、性状,从而选择最佳手术方案。根据不同阶段囊型包虫病所具有的不同声像特征,可做出正确诊断及相应的病理提示。因此,超声检查方法可作为囊型包虫病的首选检查方法。     

肝包虫病的CT诊断价值及分型（附69例临床分析）

目的：探讨肝包虫病CT诊断价值、病理基础与分型。总结肝包虫的CT影像学特点,为肝包虫的诊断提供方法学依据,以提高CT诊断肝包虫病重要性的认识。方法：收集我院200年～2009年经手术病理及临床随访证实的肝包虫病69例临床资料,根据CT表现进行对照分型。结果：69例肝包虫病包括囊型包虫病58例,泡状包虫病11例。这两种类型的肝包虫病都有其各自典型的CT征象,CT扫描诊断的准确率为97．10％。结论：应用CT扫描是肝包虫病有效而准确的诊断方法,可为手术提供可靠依据。     

肝囊性包虫病49例临床分析

目的：探讨肝囊性包虫病的诊断和治疗方法。方法：回顾性分析2009年1月-2012年12月我院收治的49例肝囊性包虫病患者的临床资料。根据流行病学史及影像学特征进行诊断。根据不同的手术方式,比较患者手术及术后恢复等情况。结果：49例患者均行B超及CT检查明确诊断。14例行肝包虫外囊完整剥除术,27例行内囊摘除＋外囊次全切除术,8例行传统内囊摘除术。结论：流行病学史及影像学检查对于肝囊性包虫病的诊断具有重要作用。肝囊性包虫病外科手术治疗方法多种多样,合理的方法应根据肝包虫囊肿的位置、大小、有无感染等情况决定。     

肝泡性包虫病的影像学诊断

目的 探讨肝泡性包虫病在B超、CT和磁3共振成像（MRI）影像学检查中的图像特征,以提高术前诊断率。方法 收集1984年1月至2000年12月经手术治疗的46例肝泡性包虫病患者的术前影像学检查资料（均行B超和CT检查,12例行MRI检查）,对照手术病理所见进行分析。结果 基于泡球蚴的基本病理形态、组织结构与病程发展演变的特殊影像学征象,可归纳为病灶浸润（41例,89.1%）、钙化（39例,84.8%）、液化空洞（37例,80.4%）3种类型,这3种类型可以并存。在3处类型中共发现9项具有特异性诊断意义的图像特征,即晕带征、钙化征、年轮征、内陷征、空腔征、岩洞征、半岛征、小泡征与地图征。结论 肝泡性包虫病具有特异性影像学征象,在9项具有特异性诊断意义的图像特征中,只要确认其中1项,即可确认。     

肝囊性包虫的CT特征分析

目的对肝囊性包虫的CT影像特征进行分析分型。方法我区为肝包虫病的高发地区。选择2002年5月～2006年5月我院138例肝包虫患者的CT影像资料综合手术病理进行分析分型。结果可将肝包虫分为六型：Ⅰ单纯型27．53％（38／138）；Ⅱ多子囊型15．22．％（21／138）；Ⅲ感染型24．63％（4／138）；Ⅳ破裂型8．69％（12／138）；Ⅴ钙化型7．97％（11／138）；Ⅵ实变型15．96％（22／38），这六型代表了囊虫的发生、发展、转归的不同阶段。结论CT对肝包虫的诊断率高，可明确包虫寄生的部位形态大小及形状。根据不同阶段包虫所具有的不同CT表现可作出明确诊断，从而选择最佳的手术方案。因此CT是肝囊性包虫的重要检查方法之一。     

肝包虫病的标准化分型及临床意义探讨

目的：建立一种肝包虫病标准化分型体系对包虫病的诊断。社区普查及确定合理的治疗方案和疗效评价体系是极其重要的。方法：根据医院总计4827例包虫病资料统计中，肝包虫病3154例（65.34%)，其中肝泡型包虫病97例（3.08%)，分析了肝包虫病的临床表现和影像学特征，并且与WTO/IWGE协作组推荐的标准化分型特点进行了对比。结果：从临床和影像学专业角度提出关于囊型包虫病的TD^-C分型和泡型包虫病的PJVA分型。结论：TD^-C和PJVM分型能更多地反映出两种包虫病的病灶范围，影像学特征，临床表现以及主要并发症。     

肝泡型包虫病的低场MRI表现特点

目的：分析肝泡型包虫病在低场强MR的影像学表现及特征,探讨低场MR在肝泡型包虫病诊断中的价值。方法：回顾性分析13例经临床和手术病理证实的肝泡型包虫病MRI影像资料。13例患者均行0.35TMR常规扫描,其中2例行增强扫描。13例均行超声检查、CT检查5例,13例均行包虫3项试验（免疫对流试验、间接血凝试验、Casoni试验）。结果：13例病灶在0.35TMR检查中,病灶实质部分于T1WI、T2WI均呈特征性低信号;13例病灶内均见小囊泡影;11例病灶呈不规则＂地图＂样分布;10例中心见不规则状液化坏死区;4例局限于肝右叶;9例呈多发,肝左右叶均侵及者9例;侵犯肝门者2例（其中黄疸2例）。结论：肝泡型包虫病行低场MRI检查具有一定的特征性表现,对肝泡型包虫病的诊断具有独特优势,依据MR典型表现可作出正确诊断。     

B超诊断异位妊娠80例

目的：探讨Ｂ超在异位妊娠中的诊断价值,方法：回顾性分析了经手术,病理证实的异位妊娠８０例Ｂ超检查的结果,结果：输卵管妊娠７８例,其中壶腹部６５例（８３．３％）峡部１３例（１６．７％）卵巢妊娠２例,声像图分型及特征,囊性包块型４例,混合包块型７２例,实质包块型２例,结论：Ｂ超诊断符合率８３．７％（６７／８０）,误漏诊率（１６．３％（１３／８０）。     

肝囊型包虫病的 CT 诊断

目的：分析肝囊型包虫病 CT 表现，探讨 CT 诊断价值，以便更好应用于临床诊治。方法：回顾性分析54例肝囊型包虫病的 CT 及临床手术病理资料，对其 CT 征象进行分类总结。结果：单发单囊9例、含子囊型33例、钙化15例、感染2例、破裂16例。结论：肝囊型包虫病有典型的 CT 特征，能反映不同的病理形态，有利于诊断及制定治疗方案。     

经阴道超声检查在异位妊娠诊断中的临床应用价值

目的：探讨经阴道超声（ TVS）检查在异位妊娠（ EP）诊断中的临床应用价值。方法：将2011年7月～2013年4月收治并经手术与病理检查证实的193例异位妊娠（ EP）患者临床经阴道超声（ TVS）诊断资料进行回顾性分析。结果：经阴道超声检查诊断异位妊娠188例,与手术病理结果比较符合率97．4％,漏诊3例,误诊2例,漏误诊率2．59％。经腹部超声检查诊断异位妊娠163例,与手术病理结果比较符合率为84．5％,漏诊22例,误诊8例,漏误诊率15．5％。 TVS诊断方法符合率明显高于TAS诊断方法,差异具有显著性（P＜0．05）;TVS诊断未破裂型77例（97．5％）,破裂型58例（86．6％）,流产型18例（85．7％）,与手术病理结果比较符合率91．6％。 TAS诊断未破裂型61例（77．2％）,破裂型51例（76．1％）,流产型14例（66．7％）,与手术病理结果比较符合率75．4％,2种超声诊断方法符合率比较,差异具有统计学意义（P＜0．05）。结论：通过与手术病理检查结果比较,对于异位妊娠（ EP）诊断经阴道超声（ TVS）较经腹超声（ TAS）检查准确性高,且图像清晰、直观可作为早期异位妊娠诊断的首选方法。     

Treatment of intracranial hydatid cysts

Background  Echinococcosis is still endemic in many countries, including China, where it is especially prevalent in the northwest. The aim of this study was to enrich the international literature about the treatment of intracranial hydatid cysts.

Methods  We retrospectively reviewed the clinical features, radiological manifestations, and surgical outcome of 97 patients with intracranial hydatid cysts, who received surgical treatment at the Neurosurgical Department of First Affiliated Hospital of Xinjiang Medical University from 1985 to 2010 and followed up the patient via sending a questionnaire or telephone contact. Clinical outcome was evaluated using the Karnofsky Performance Scale Index.

Results  Headache and vomiting were the most common initial symptoms in our patients. Neurological deficits caused by the mass effect of the cysts were seen in 82 cases. On the X-ray, significant bone erosion was seen in only two cases with epidural hydatid cysts. Round-shaped and thin-walled homogeneous low-density cystic lesions without surrounding edema and enhancement were the main findings on computerized tomography (CT) in 95 patients with intraparenchymal hydatid cysts, while two cases with epidural hydatid cysts presented as a heterodensity lesions. On magnetic resonance imaging (MRI), hydatid cyst presented as a round-shaped low signal lesion in T1-weighted images and high signal lesion in T2-weighted images, without enhancement after contrast media injection, while the two cases with epidural cysts presented as mixed signal masses. Surgical removal of cyst was performed in all cases. Total removal was achieved in 93 cases without rupturing the cyst wall. Only two cysts ruptured during the dissection, resulting in two surgery-related mortalities. There was no other additional neurological deficit caused directly by surgery. In 97.2% of the patients, the Karnofsky Performance Scale score was 80 to 90 at the last follow-up.

Conclusions  Intracranial hydatid cyst is still a main cause of increased intracranial pressure among the patients in endemic areas for echinococcosis. CT and MRI are the best diagnostic methods and surgery is the treatment of choice for intracranial hydatid cysts.

     

Pericyst may be a new pharmacological and therapeutic target for hydatid disease

Background  Most hydatid cysts with calcified walls are biologically and clinically silent and inactive. Transforming growth factor-beta 1 (TGF-β1) plays a critical role in the calcification process of cells. The aim of this study was to assess the effect of modulating TGF-β1 signaling on the calcification of hydatid cysts.

Methods  Pericyst cells isolated from hepatic hydatid cysts were cultured with osteogenic media. These cells were assessed for alkaline phosphatase activity and mineralization capacity using Alizarin Red staining. Cells were also treated with recombinant human TGF-β1 and TGF-β inhibitor, and the expression profiles of osteoblast markers (RUNX2, osterix, and osteocalcin) were analyzed using Western blotting. The effects of inhibiting TGF-β1 signaling on calcification of pericyst walls were assessed using different doses of TGF-β inhibitor for 7 weeks in a preclinical disease model of liver cystic echinococcosis.

Results  Cells within the pericyst displayed high levels of alkaline phosphatase activity and mineralized nodule formation, as induced by osteogenic media. These activities, as well as expression profiles of osteoblast markers (RUNX2, osterix, and osteocalcin) could be inhibited by addition of recombinant human TGF-β1 (rhTGF-β1) and enhanced by TGF-β inhibitor. In the animal model of cystic echinococcosis, inhibition of TGF-β1 signaling increased calcification of the pericyst wall, which was associated with decreased cyst load index and lower viability of protoscoleces.

Conclusions  Cells within the pericysts adopt an osteoblast-like phenotype and have osteogenic potential. Inhibition of TGF-β1 signaling increases hydatid cyst calcification. Pharmacological modulation of calcification in pericysts may be a new therapeutic target in the treatment of hydatid disease.

     

肝包虫病的螺旋CT诊断

目的:提高对肝包虫病的螺旋CT表现的认识。方法:回顾分析经本院螺旋CT检查及手术病理证实的21例肝包虫病螺旋CT表现。结果:囊型包虫病18例,其中单纯囊肿8例,表现为圆形水样密度区。多子囊型10例,表现为在一个大囊内可见数量不等的更低密度小圆形低密度区,边界清晰。钙化14例,为囊壁壳状钙化囊内不定形条片状钙化。包虫囊肿合并感染4例,表现为囊壁增厚,强化明显。泡型包虫病3例,呈不规则及不均匀密度影,所有病灶内均有钙化灶,其中1例病灶边缘有晕样改变区。所有病例CT均诊断正确。结论:螺旋CT可以很好显示肝包虫病病灶,对肝包虫病具有较高的诊断率。     

Continuous long-term albendazole therapy in intraabdominal cystic echinococcosis

Ａｌｂｅｎｄａｚｏｌｅｈａｓｂｅｅｎｗｉｄｅｌｙｕｓｅｄｉｎｔｈｅｔｒｅａｔｍｅｎｔｏｆｃｙｓｔｉｃｅｃｈｉｎｏｃｏｃｃｏｓｉｓ ,ｂｕｔｒｅｌａｔｉｖｅｌｙｆｅｗｌｏｎｇ ｔｅｒｍｆｏｌｌｏｗ ｕｐｒｅｓｕｌｔｓａｒｅａｖａｉｌａｂｌｅｔｏｅｖａｌｕａｔｅｌｏｎｇ ｔｅｒｍｅｆｆｉｃａｃｙａｎｄｓａｆｅｔｙ Ｉｎｔｈｉｓｓｔｕｄｙ ,ｗｅｆｏｌｌｏｗｅｄｕｐ 15ｐａｔｉｅｎｔｓｗｈｏｒｅｃｅｉｖｅｄｃｏｎｔｉｎｕｏｕｓｌｏｎｇ ｔｅｒｍａｌｂｅｎｄａｚｏｌｅｔｈｅｒａｐｙ ;ｃｌｉｎｉｃａｌｔｈｅｒａｐｅ…     

11例肝包虫外囊剥除术临床初步观察

目的：探讨肝包虫外囊剥除术治疗肝包虫病的疗效。方珐：采用肝包虫外囊剥除术治疗11例肝包虫病患者。结果：全组病人术后恢复良好，无胆瘘、出血、感染等并发症。结论：肝包虫外囊剥除术治疗肝包虫病是一种合理而可行的新术式，可解决以往传统的内囊摘除术由于囊液外溢导致的复发问题，远期临床疗效尚需积累更多的病例和进行更长期的随访以进一步观察。     

肾包虫囊肿的CT诊断(附3例报告)

本文报告经手术证实的3例肾包虫囊肿的CT表现。其特征性表现是:(1)卵圆形或圆形水样密度囊肿。(2)母囊内有子囊。(3)囊膜剥离征象。(4)囊壁钙化。并讨论了本病的破裂感染和与先天性肾囊肿的鉴别诊断。     

Diagnosis and classification of hepatic echinococcosis by ultrasonography

OBJECTIVE: To make an early and correct diagnosis of hepatic echinococcosis. METHODS: A total of 1092 patients with hepatic echinococcosis underwent operation in our hospital between 1984 and 1995. Of these patients, 427 (39.1%) were cases with complications, including secondary infection, rupture, obstructive jaundice, anaphylactic shock, disseminated implantation with resultant multiple echinococcosis and portal hypertension. The ultrasonic examination has been generally used in clinical practice for comprehensive evaluation which can dectedct the preoperative diagnostic accuracy rate. RESULTS: B-mode ultrasonography can be used not only to detect the location, dimension and pathological characteristics of hydatid cyst but also to show the pathological changes of various complications caused by echinococcosis. Seven patterns specific ultrasonic scanning images were revealed. In this series the diagnostic accuracy rate reached 98.8%. CONCLUSIONS: Ultrasonic examination is harmless to human body, and has been widely used in combination with immunological tests in clinical and epidemiological studies to detect the asymptomatic parasite carriers in early stage and to improve the preoperative diagnostic accuracy rate.     

Diagnosis and classification of hepatic echinococcosis by ultrasonography.

ＤｉａｇｎｏｓｉｓａｎｄｃｌａｓｉｆｉｃａｔｉｏｎｏｆｈｅｐａｔｉｃｅｃｈｉｎｏｃｏｃｃｏｓｉｓｂｙｕｌｔｒａｓｏｎｏｇｒａｐｈｙＸｕＭｉｎｇｑｉａｎ徐明谦，ＹｕＬａｎ于兰，ＳｈｉＭｅｉ石梅ａｎｄＨｅＸｉａｏｑｉ何晓齐ＣｌｉｎｉｃａｌＤｉｖｉｓｉｏｎ...     

半月板囊肿的MRI诊断价值

目的分析膝关节半月板囊肿的MRI表现,评价其MRI诊断的价值。方法收集MRI检出并经手术病理证实的18例膝关节半月板囊肿,回顾性分析其MRI表现。结果半月板旁型囊肿13例,半月板内型囊肿1例,滑膜囊肿4例。半月板囊肿多呈类圆形,边缘光滑的囊性肿块,信号均匀,T1WI呈等或稍低信号,T2WI呈高信号。典型表现呈“吹气球征”。结论MRI对膝关节半月板囊肿的诊断具有重要价值,可作为半月板囊肿的首选检查方法。     

Radiological appearances of hydatid disease in Wales

Thirty six patients with hydatid disease have been investigated in the Radiology Departments of Cardiff hospitals between June 1973 and June 1984; thirty two of these patients are likely to have acquired the disease in Wales. There were 16 hepatic cysts, 3 renal cysts, 2 cerebral cysts, 15 pulmonary cysts, 1 pleural cyst, 1 recurrent spinal cyst, and 1 cyst of the broad ligament. The radiological features are discussed. These patients emphasize the higher incidence of hydatid disease in Wales, compared with other regions of the United Kingdom, and the need to consider this diagnosis in Welsh patients from rural areas, who have large pulmonary opacities, or hepatic, renal, or cerebral cystic abnormalities.